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Attention, chocolate lovers: You may not be able to help yourselves. Swiss and British scientists have linked the widespread love of chocolate to a chemical "signature" that may be programmed into our metabolic systems.
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Low Back Pain

Overview, Causes, & Risk Factors

Low back pain refers to pain or discomfort in the lower back.

What is going on in the body?

Low back pain may involve the muscles, joints, or nerves of the lower back. It may also be referred pain, which means the pain is actually coming from another organ, such as the kidneys.

What are the causes and risks of the condition?

Low back pain may be caused by a number of spinal disorders. Following are some common causes:

fibromyalgia, a condition that causes trigger points in body tissues, including the low back

osteomyelitis, or bone infection

ruptured disks, which involve the soft disks between the vertebrae of the spine

spinal degeneration, which may involve arthritis

spinal stenosis, or narrowing of the disk spaces with aging

sprains or strains of the muscles and other soft tissue in the back

tumors of the spine

A person with disorders of certain body organs may experience referred pain in the low back. These disorders include:

aneurysms

appendicitis

kidney disease

ovarian disorders

pelvic inflammatory disease, and other infections in the pelvic area

urinary tract infection

Following are risk factors that increase a person's risk for low back pain:

activities, such as driving a car, that pass vibrations along the spine

lack of physical activity

obesity

old age

smoking

Symptoms & Signs

What are the signs and symptoms of the condition?

Low back pain may range from a dull ache to severe, disabling pain. The individual may have related symptoms, including the following:

decreased ability to flex the knee

decreased ability to move the foot and toes in certain directions

numbness, burning, or tingling in the leg

pain that travels down the leg to the back of the thigh and calf

Diagnosis & Tests

How is the condition diagnosed?

Diagnosis of low back pain begins with a medical history and physical exam. Depending on the suspected cause of the problem, the provider may order diagnostic tests, such as:

blood and urine tests

a bone scan

CT or MRI scans

an electromyogram, or EMG, which measures muscle response to nerve stimulation

a myelogram, which uses a contrast agent and X-rays to detect abnormalities along the spine

a nerve conduction velocity test, or NCV, which measures transmission along the nerve

Prevention & Expectations

What can be done to prevent the condition?

Proper lifting techniques are important to avoid a ruptured disk. These techniques can be enhanced by the use of an abdominal support belt. Other preventive measures are as follows:

regular physical activity

rest breaks to interrupt long periods of vibration, such as driving a car

smoking cessation for individuals who smoke

weight management for people who are obese

What are the long-term effects of the condition?

Low back pain is a leading cause of disability and missed work in developed countries. Those affected may be unable to perform activities they enjoy. Chronic pain can result in depression, lack of productivity, and drug abuse. If there is nerve damage, the person may have weakness, numbness, and loss of muscle mass.

What are the risks to others?

Low back pain is not contagious and poses no risk to others.

Treatment & Monitoring

What are the treatments for the condition?

Low back pain caused by strains or sprains will get better on its own within four weeks, with or without treatment. People with more serious conditions, such as a ruptured disk, may benefit from treatment. A ruptured disk is generally treated conservatively at first. Following are some initial treatments that may be used:

anti-inflammatory pain medication, such as ibuprofen, ketoprofen, flurbiprofen, or naproxen

activity limitations

application of heat

massage

muscle relaxants, such as carisoprodol

a specialized exercise program

If conservative treatment is not successful, the healthcare provider may recommend surgery. The following operations may be helpful for people who have a ruptured disk:

diskectomy or laminectomy, which allows the surgeon to remove the ruptured disk and relieve nerve pressure

injection of chymopapain, an enzyme, into the disk to dissolve it

nucleoplasty, which involves inserting a needle into the disk and applying heat with a special instrument

spinal fusion, which involves the joining of two or more vertebrae

What are the side effects of the treatments?

Side effects of medicines include allergic reactions and stomach upset. Surgery is associated with a risk of infection, bleeding, and allergic reaction to anesthesia.

What happens after treatment for the condition?

After conservative treatment of a ruptured disk, a person can usually resume activity as tolerated. Symptoms may recur every now and then, requiring repeated treatment. Ninety percent of the time, surgery relieves symptoms and the person can slowly resume normal activities. Physical therapy can be helpful to teach appropriate body mechanics and lifting techniques.

How is the condition monitored?

Any new or worsening symptoms should be reported to the healthcare provider.

Attribution

Author:Ann Reyes, Ph.D.
Date Written:
Editor:Crist, Gayle P., MS, BA
Edit Date:08/31/01
Reviewer:Eileen McLaughlin, RN, BSN
Date Reviewed:09/05/01

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